US11451698B2 - Medical system and control unit - Google Patents
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- US11451698B2 US11451698B2 US16/617,528 US201816617528A US11451698B2 US 11451698 B2 US11451698 B2 US 11451698B2 US 201816617528 A US201816617528 A US 201816617528A US 11451698 B2 US11451698 B2 US 11451698B2
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Images
Classifications
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00002—Operational features of endoscopes
- A61B1/00004—Operational features of endoscopes characterised by electronic signal processing
- A61B1/00009—Operational features of endoscopes characterised by electronic signal processing of image signals during a use of endoscope
- A61B1/000095—Operational features of endoscopes characterised by electronic signal processing of image signals during a use of endoscope for image enhancement
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- A—HUMAN NECESSITIES
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- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00002—Operational features of endoscopes
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- A61B1/00006—Operational features of endoscopes characterised by electronic signal processing of control signals
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- A61B1/00—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor
- A61B1/00002—Operational features of endoscopes
- A61B1/00043—Operational features of endoscopes provided with output arrangements
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- A61B1/04—Instruments for performing medical examinations of the interior of cavities or tubes of the body by visual or photographical inspection, e.g. endoscopes; Illuminating arrangements therefor combined with photographic or television appliances
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- A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
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- G—PHYSICS
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- G02B21/365—Control or image processing arrangements for digital or video microscopes
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- H04N23/555—Constructional details for picking-up images in sites, inaccessible due to their dimensions or hazardous conditions, e.g. endoscopes or borescopes
Definitions
- the present disclosure relates to a medical system and a control unit.
- Patent Document 1 discloses that, in an endoscope apparatus that can use a probe-type endoscope, two images are accurately matched and a composite image is generated regardless of the position of a probe tip portion and the degree of curvature of a scope tip portion.
- a medical imaging apparatus there are cases where a plurality of cameras is used at the same time.
- a brain surgery or the like there is a case where an exoscope is used when a near part of the surgical field is observed, and an endoscope is used when a deep part of the surgical field is observed.
- images captured by a plurality of cameras are displayed as they are, two images have different appearances, which makes an observer feel uncomfortable.
- disadvantages such as difficulty in recognizing that subjects having different appearances are the same subject and difficulty in recognizing the relationship between the two images are caused.
- Patent Document 1 specifies the enlargement/reduction magnification and the phase shift amount on the basis of the protruding length of the probe tip portion and the curvature angle of the scope tip portion, and makes the size of an observation object such as a lesion coincident with the size of an observation object in a normal observation image.
- the technology disclosed in Patent Document 1 is to make the image sizes coincident with each other in a case where the positional relationship of one image with respect to another image is defined in advance, but does not at all assume any measure for regulating the appearance between two images according to the images captured by different apparatuses.
- a medical system including a plurality of surgical imaging apparatuses and a control unit to which each of the surgical imaging apparatuses is connected, the control unit including a signal processing unit that links images captured by the respective surgical imaging apparatuses.
- a control unit to which each of a plurality of surgical imaging apparatuses is connected is provided, the control unit including a signal processing unit that links images captured by the respective surgical imaging apparatuses.
- a medical system including a plurality of surgical imaging apparatuses, a control unit to which each of the surgical imaging apparatuses is connected, and an integrated apparatus to which each of a plurality of the control units is connected, the integrated apparatus including a signal processing unit that links images captured by the respective surgical imaging apparatuses.
- FIG. 1 is a schematic diagram illustrating an outline of the configuration of a surgical system according to each embodiment of the present disclosure.
- FIG. 2 is a schematic diagram illustrating a configuration further including an input module that relays between a camera unit and a camera control unit (CCU), in addition to the configuration in FIG. 1 .
- CCU camera control unit
- FIG. 3 is a schematic diagram illustrating the configuration and action of a signal processing unit in the CCU.
- FIG. 4 is a schematic diagram illustrating a case where an exoscope and an endoscope are used together at the same time to observe a subject.
- FIG. 5 is a schematic diagram illustrating methods of displaying an exoscopic image and an endoscopic image.
- FIG. 6 is a schematic diagram illustrating a processing method for displaying the color tone of an image of the endoscope in accordance with the color tone of an image of the exoscope.
- FIG. 7 is a schematic diagram for explaining an example of adapting shake between the exoscopic image and the endoscopic image.
- FIG. 8 is a schematic diagram for explaining an example of adapting shake between the exoscopic image and the endoscopic image.
- FIG. 9 is a schematic diagram illustrating an example of adapting the brightness (luminance) and contrast between the exoscopic image and the endoscopic image.
- FIG. 10 is a schematic diagram illustrating an example of adapting the sense of resolution and depth of field between the exoscopic image and the endoscopic image.
- FIG. 11 is a schematic diagram illustrating an example of adapting noise between the exoscopic image and the endoscopic image.
- FIG. 12 is a schematic diagram illustrating an example of adapting the image orientation between the exoscopic image and the endoscopic image.
- FIG. 13 is a schematic diagram illustrating an example of a case where an exoscopic image that can be taken in three dimensions (3D) and an endoscopic image that can be taken in 3D are used together.
- FIG. 14 is a schematic diagram illustrating a system including a plurality of CCUs, to each of which a plurality of camera units is connected, in which each CCU is connected to an integrated apparatus 600 .
- this surgical system 1000 is configured from a plurality of camera units 100 , a CCU (control unit) 200 to which a plurality of cameras can be connected and which is capable of a plurality of outputs, and a plurality of monitors 300 .
- the surgical system 1000 generates a plurality of output images by signal processing from information in a plurality of input signals from the plurality of camera units 100 , and outputs the generated output images to the monitors 300 .
- FIG. 2 is a schematic diagram illustrating a configuration example of a system further including an input module (camera head unit) 400 that relays between the camera unit 100 and the CCU 200 in addition to the configuration in FIG. 1 , in which the surgical system 1000 inputs an image to the CCU 200 after performing a pre-process in the input module 400 .
- the input module 400 is used, for example, to ensure compatibility between the camera unit 100 and the CCU 200 .
- the plurality of camera units 100 is a plurality of cameras used for surgery and, for example, represents an endoscope (a rigid endoscope or a flexible endoscope), an extracorporeal scope (exoscope), a microscope, a surgical field camera, and the like.
- the surgical system 1000 may include a light source apparatus that irradiates the subject when the camera unit 100 images the subject.
- the plurality of camera units 100 is sometimes used at the same time during surgery.
- a brain surgery or the like there is a case where an exoscope is used when a near part of the surgical field is observed, and an endoscope is used when a deep part of the surgical field is observed.
- a conceivable case for a brain aneurysm in the open brain includes a case where the front side of the affected part is observed with an exoscope, and the back side of the affected part is observed by inserting an endoscope, and the like. In such a case, in the present embodiment, a process of adapting the appearance of respective images between the plurality of camera units 100 is performed.
- a process of linking the images of the plurality of camera units 100 with each other is performed.
- Examples of the combination of the plurality of camera units 100 used at the same time include an endoscope and an exoscope, an endoscope and a surgical microscope, a rigid endoscope and a flexible endoscope, and an endoscope, a surgical field camera, and the like.
- the endoscope mirror is suitable for the case of observing the details of the subject, if the endoscope is moved away from the subject in order to take an image of a wider range, the image is distorted.
- the exoscope includes a dedicated optical system and is capable of capture an image without causing distortion in such a case; there is thus an advantage that, for example, it is easy to perform a surgery because a sufficient distance can be ensured between the subject and the exoscope.
- the surgical field camera is a camera that takes an image of the entire surgical situation.
- FIG. 3 is a schematic diagram illustrating the configuration and action of the signal processing unit 210 in the CCU 200 in a system in which two cameras, namely, an exoscope and an endoscope are connected to the CCU 200 as the plurality of camera units 100 .
- the signal processing unit 210 is provided in the CCU 200 to which the plurality of camera units 100 is connected, and performs a process so as to adapt the appearance between an image generated on the basis of an imaging signal obtained from one of the camera units 100 and an image generated on the basis of an imaging signal obtained from the other of the camera units 100 .
- the signal processing unit 210 includes an adjustment parameter calculation unit 212 , an adjustment parameter application unit 214 , and an adjustment parameter application unit 216 .
- the adjustment parameter calculation unit 212 accepts inputs of image information 10 from the exoscope (hereinafter also referred to as an exoscopic image) and image information 12 from the endoscope (hereinafter also referred to as an endoscopic image).
- an adjustment trigger 14 is input to the adjustment parameter calculation unit 212 .
- the adjustment trigger 14 is information defined from the outside or an input image, and is information serving as a trigger for performing adjustment using an adjustment parameter. For example, in a case where it is detected that both of the exoscopic image 10 and the endoscopic image 12 have the same subject, the adjustment trigger occurs.
- the adjustment parameter is a parameter for performing the process of adapting the appearance between the exoscopic image 10 and the endoscopic image 12 .
- the process of adapting the appearance between the exoscopic image 10 and the endoscopic image 12 is not performed, and the exoscopic image 10 and the endoscopic image 12 are processed independently.
- the adjustment parameter calculation unit 212 calculates adjustment parameters relating to the color, luminance, contrast, depth of field, noise, angle of view, image orientation, and the like from the exoscopic image 10 , or the endoscopic image 12 , or both of the exoscopic image 10 and the endoscopic image 12 .
- the adjustment parameter is sent to one or both of the adjustment parameter application units 214 and 216 .
- the adjustment parameter application unit 214 applies the adjustment parameter to the exos image 10 .
- the adjustment parameter application unit 216 applies the adjustment parameter to the endoscopic image 12 .
- the signal processing unit 210 applies the adjustment parameter to one or both of the exoscopic image 10 and the endoscopic image 12 , and generates an output image of each image.
- the appearance can be adapted between the exoscopic image 10 and the endoscopic image 12 , and it is possible to prevent inconsistency from being caused in the appearance of the subject when the user observes the image obtained from one of the camera units 100 after observing the image obtained from the other of the camera units 100 .
- the adjustment trigger 14 can be caused to occur according to the user operation, the state (position) of an operating surgeon, information regarding a connected device, and the like. In a case where the adjustment trigger 14 is caused to occur by the user operation, the adjustment trigger 14 occurs when the user operates an operation input unit of the CCU 200 .
- the adjustment trigger 14 is caused to occur according to the state of an operating surgeon, for example, the position of the operating surgeon is determined from the image of the surgical field camera installed in the surgical room, and the adjustment trigger 14 is caused to occur in a case where it is determined, on the basis of the position of the operating surgeon, that the operating surgeon is performing observation with the endoscope in addition to observation with the exoscope. Furthermore, in a case where the adjustment trigger is caused to occur on the basis of information regarding a connected device, identification information of the device is acquired from each of the plurality of camera units 100 connected to the CCU 200 , and the adjustment trigger 14 is caused to occur in a case where a plurality of camera units 100 for which the adjustment trigger 14 is predefined to occur is connected to the CCU 200 .
- the endoscopic image 12 may be adapted with the exoscopic image 10 with the exoscopic image 10 as a reference, or the exoscopic image 10 may be adapted with the endoscopic image 12 with the endoscopic image 12 as a reference.
- each of the exoscopic image 10 and the endoscopic image 12 may be adapted with a target image serving as a reference for adapting the appearance.
- FIG. 4 is a schematic diagram illustrating a case where an exoscope 110 and an endoscope 120 are used together at the same time to observe a subject.
- the exoscope 110 is used when a near part of the surgical field is observed, and the endoscope 120 is used when a deep part of the surgical field is observed, a case where the exoscope 110 and the endoscope 120 are used together at the same time is conceivable.
- the exoscope 110 and the endoscope 120 irradiate the subject using illumination by different light sources.
- the exoscope 110 irradiates the subject with illumination by a light source apparatus (1) 400
- the endoscope 120 irradiates the subject 500 with illumination by a light source apparatus (2) 410 .
- the exoscope 110 and the endoscope 120 receive light that has passed through different lenses with different sensors. For this reason, the exoscope 110 and the endoscope 120 usually have different color tones from each other even if a development process is performed with the same parameters.
- FIG. 5 is a schematic diagram illustrating methods of displaying the exoscopic image 10 and the endoscopic image 12 .
- there are following methods of displaying two images a method in which two images are displayed on two monitors 300 placed side by side, and a method in which two images are temporally switched and displayed on one monitor 300 .
- two images with different color tones are displayed as they are, the observer will be made feel uncomfortable because the color tones of the two images are different.
- even if the same subject is imaged and displayed it becomes difficult to recognize that subjects having different color tones are the same subject, which causes difficulty in associating the two images.
- the color tone of the endoscopic image 12 and the color tone of the exoscopic image 10 are adapted with each other when displayed.
- the adjustment parameter to the exoscopic image, or the endoscopic image, or both of the exoscopic image and the endoscopic image
- the color tone is regulated between the image of the exoscope 110 and the image of the endoscope 120 .
- FIG. 6 is a schematic diagram illustrating a processing method for displaying the color tone of an image of the endoscope 120 in accordance with the color tone of an image of the exoscope 110 .
- the linear formula in formula (1) serves as a conversion formula of the RGB values from the endoscopic image 12 to the exoscopic image 10 .
- the coefficients (a to i) for conversion correspond to adjustment parameters. Therefore, the color tone of the endoscopic image 12 can be adapted with the color tone of the exoscopic image 10 .
- FIGS. 7 and 8 a process of adapting shake between the exoscopic image 10 and the endoscopic image 12 (camera shake removal process) in a case where the exoscope 110 and the endoscope 120 are used together at the same time to perform observation will be described on the basis of FIGS. 7 and 8 .
- the exoscope 110 is usually fixed by a fixing tool 20 , but the endoscope 120 is held by hand by a scopist or an operating surgeon. Accordingly, shake is caused in the endoscopic image 12 in some cases.
- FIG. 8 is a schematic diagram illustrating a processing method for adapting shake between the exoscopic image 10 and the endoscopic image 12 .
- FIG. 8 it is detected by block matching that an area A of the exoscopic image 10 and an area B of the endoscopic image 12 have the same subject and are a common area.
- the exoscopic image 10 of the exoscope 110 fixed by the fixing tool 20 has no shake as illustrated in the area A in FIG. 8 .
- the endoscope 120 is supported by a person, shake is caused in the endoscopic image 12 as illustrated in the area B in FIG. 8 . Accordingly, the endoscopic image 12 in which shake is caused is adapted with the exoscopic image 10 in which no shake is caused.
- the endoscopic image 12 is tracked in accordance with the exoscopic image 10 , and shake in the endoscopic image 12 is corrected by removing a shake component of the endoscopic image 12 .
- shake in the endoscopic image 12 is removed in accordance with the stationary exoscopic image 10 , it is possible to suppress a sense of discomfort caused when the user moves the line of sight between the exoscopic image 10 and the endoscopic image 12 .
- shake in the endoscopic image 12 is corrected without using the exoscopic image 10 .
- shake correction for the endoscopic image 12 is performed by recognizing shake in the endoscopic image 12 from the translational, enlargement, and rotational components of the endoscopic image 12 and performing multiplication by the inverse matrix of the shake.
- FIG. 9 is a schematic diagram illustrating an example of adapting the brightness (luminance) and contrast between the exoscopic image 10 and the endoscopic image 12 .
- the method of calculating the brightness conversion coefficient of each color can be performed in a similar manner to the case of adapting the color tone described with reference to FIG. 6 .
- luminance Y obtained by conversion from the RGB values is adapted
- luminance Y 1 of the exoscopic image 10 is converted into luminance Y 2 of the endoscopic image 12 by following formula (2).
- the brightness is adjusted by applying gain to a darker image depending on the relationship of R, G, and B, or Y.
- FIG. 9 illustrates an example in which the exoscopic image 10 is adapted with the endoscopic image 12 .
- the conversion coefficient may be applied to the entire screen by calculating one coefficient mainly from the center area of the image, or the coefficient may be applied for each area by individually calculating the coefficient for each corresponding area in the image. By individually calculating the coefficient for each corresponding area and applying the coefficient to each area, the contrast can be made coincident between the exoscopic image 10 and the endoscopic image 12 .
- FIG. 10 is a schematic diagram illustrating an example of adapting the sense of resolution and depth of field between the exoscopic image 10 and the endoscopic image 12 .
- the conversion coefficient is calculated by replacing the RGB values in FIG. 6 and formula (1) with a value DR indicated by a difference between the maximum value and the minimum value of pixel values in a predetermined area around the pixel of interest. For the areas A and B that have been matched that both of the areas have the same position of the same subject, in a case where the respective values of the difference DR at corresponding positions (indicated by x marks in FIG.
- a difference between the maximum value and the minimum value around the pixel of interest of each image can be expressed by a linear formula as illustrated in following formula (3).
- a reference character a denotes a conversion coefficient.
- the strength of an enhancement process for an image with a smaller DR is increased depending on the DR ratio.
- the conversion coefficient may be applied to the entire screen by calculating one coefficient mainly from the center area of the image, or the coefficient may be applied for each area by individually calculating the coefficient for each corresponding area.
- FIG. 11 is a schematic diagram illustrating an example of adapting noise between the exoscopic image 10 and the endoscopic image 12 .
- the method of calculating the conversion coefficient is similar to the case of adapting the color tone described with reference to FIG. 6 .
- the conversion coefficient is calculated by assuming that the RGB values in FIG. 6 and formula (1) are replaced with a standard deviation ⁇ of pixel values in a predetermined area around the pixel of interest.
- NR noise reduction
- G the ratio of noise G
- FIG. 12 is a schematic diagram illustrating an example of adapting the image orientation and angle of view between the exoscopic image 10 and the endoscopic image 12 .
- geometric correction is performed on the basis of the matching result between the exoscopic image 10 and the endoscopic image 12 , and correction for adapting the orientation of the endoscopic image 12 with the orientation of the exoscopic image 10 is performed.
- the positional relationship and the correspondence between the exoscopic image 10 and the endoscopic image 1 are acquired by block matching or the like, and geometric correction is performed depending on the result of the acquired information.
- the image orientation of the endoscopic image 12 is fit to the image orientation of the exoscopic image 10 .
- the orientation of the endoscope shown in the exoscopic image 10 may be detected such that turning on and off of the correction is automatically switched according to the shown orientation of the endoscope. For example, if the endoscope is in an orientation in which the top and bottom are reversed between the endoscopic image 12 and the exoscopic image 10 , the correction is turned on.
- FIG. 13 is a schematic diagram illustrating an example of a case where the exoscopic image 10 that can be taken in 3D and the endoscopic image 12 that can be taken in 3D are used together.
- the viewpoint is switched from the monitor 300 that displays the 3D image of the exoscopic image 10 to the monitor 300 that displays the 3D image of the endoscopic image 12
- the sense of depth at the point of interest on the exoscopic image 10 differs significantly from the sense of depth at the corresponding point of interest (corresponding point) on the endoscopic image 12 , the user feels more uncomfortable when switching the line of sight.
- the sense of depth is regulated to the same extent between the point of interest on the exoscopic image 10 and the corresponding point on the endoscopic image 12 , and it is thus possible to mitigate the sense of discomfort when the user switches the line of sight.
- the parallax adjustment may not be performed, or a process of lowering the degree of parallax adjustment or the like may be performed.
- the point of interest on the image in the present embodiment may be designated by the user using a user interface (UI) such as a pointing device, or the point of interest may be automatically detected by a line-of-sight detection device.
- UI user interface
- a surgical instrument such as an electric knife or forceps may be detected such that, for example, the tip of an electric knife or forceps, which is often noticed by a surgeon as a user on the image, is set as a point of interest.
- a central portion of the image which is generally likely to gather viewpoints, may be set as a point of interest.
- FIG. 14 is a schematic diagram illustrating a system 2000 including a plurality of CCUs 200 , to each of which a plurality of camera units 100 is connected, in which each CCU 200 is connected to the integrated apparatus 600 .
- the signal processing unit 210 illustrated in FIG. 3 is provided not in the CCU 200 but in the integrated apparatus 600 .
- the integrated apparatus 600 performs a process of adapting the appearance between images sent from the respective camera units 100 by the function of the signal processing unit 210 . Therefore, according to the system 2000 illustrated in FIG. 14 , it is possible to unify the appearance of the images of the respective camera units 100 connected to the respective CCUs 200 connected to the integrated apparatus 600 .
- the present disclosure can also be applied to a case where observation is performed by switching between the exoscopic image 10 and the endoscopic image 12 .
- the image immediately before switching is held, and various corrections for the image after switching are performed using the held image.
- the image to be corrected is not limited to the exoscopic image 10 or the endoscopic image 12 , and may be changed according to the situation.
- a medical system including:
- control unit to which each of the surgical imaging apparatuses is connected, the control unit including a signal processing unit that links images captured by the respective surgical imaging apparatuses.
- a plurality of the surgical imaging apparatuses includes at least two of an endoscope, an extracorporeal scope, a microscope, or a surgical field camera.
- the signal processing unit performs a process for the linking according to occurrence of an adjustment trigger
- the adjustment trigger occurs by a user operation.
- the signal processing unit performs a process for the linking according to occurrence of an adjustment trigger
- the adjustment trigger occurs in a case where a plurality of the surgical imaging apparatuses images a same subject.
- the signal processing unit performs a process for the linking according to occurrence of an adjustment trigger
- the adjustment trigger occurs according to a state of an operating surgeon who performs a surgery.
- the signal processing unit performs a process for the linking according to occurrence of an adjustment trigger
- the adjustment trigger occurs according to identification information for identifying a plurality of the surgical imaging apparatuses.
- control unit to which each of a plurality of surgical imaging apparatuses is connected, the control unit including a signal processing unit that links images captured by the respective surgical imaging apparatuses.
- a medical system including:
- the integrated apparatus including a signal processing unit that links images captured by the respective surgical imaging apparatuses.
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Abstract
Description
- Patent Document 1: Japanese Patent Application Laid-Open No. 2011-55939
Y2=a·Y1 (2)
DR B =a·DR A (3)
σA =a·σ B (4)
- 100 Camera unit
- 200 CCU
- 210 Signal processing unit
- 600 Integrated apparatus
- 1000 Surgical system
Claims (19)
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
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JP2017110569 | 2017-06-05 | ||
JPJP2017-110569 | 2017-06-05 | ||
JP2017-110569 | 2017-06-05 | ||
PCT/JP2018/012730 WO2018225346A1 (en) | 2017-06-05 | 2018-03-28 | Medical system and control unit |
Publications (2)
Publication Number | Publication Date |
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US20200128169A1 US20200128169A1 (en) | 2020-04-23 |
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JPWO2018225346A1 (en) | 2020-04-02 |
EP3636135A4 (en) | 2020-06-10 |
JP7163913B2 (en) | 2022-11-01 |
EP3636135A1 (en) | 2020-04-15 |
CN110678116A (en) | 2020-01-10 |
US20200128169A1 (en) | 2020-04-23 |
WO2018225346A1 (en) | 2018-12-13 |
CN110678116B (en) | 2022-11-04 |
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